Montelukast Stada (Montelukast)

• Montelukast acts on the leukotriene pathway to control airway inflammation and allergic symptoms in several respiratory conditions.
• Asthma: provides maintenance therapy that reduces the frequency of exacerbations and improves overall lung function.
• Allergic rhinitis: alleviates nasal congestion, sneezing, and itching by blocking leukotriene‑mediated inflammation.
• Exercise‑induced bronchoconstriction: prevents airway narrowing during physical activity, helping maintain exercise tolerance.

• Montelukast selectively antagonizes the cysteinyl leukotriene receptor CysLT1 located on airway smooth‑muscle cells, mast cells, and eosinophils. By blocking this receptor, it inhibits the actions of leukotrienes that cause bronchoconstriction, mucus secretion, vascular permeability, and inflammatory cell recruitment, thereby reducing airway hyper‑responsiveness and allergic inflammation. The effect is dose‑dependent and contributes to long‑term control of asthma symptoms and relief of allergic rhinitis.

Montelukast is generally well tolerated, but several adverse reactions have been reported.

Common Side Effects

• Headache: mild to moderate head pain reported by some patients.
• Abdominal pain: discomfort or cramping in the stomach area.
• Cough: occasional dry or productive cough.
• Nausea: feeling of queasiness that may lead to vomiting.

Serious or Rare Side Effects

• Allergic reactions such as rash, angioedema, or anaphylaxis.
• Mood changes, including depression or suicidal thoughts.
• Elevated liver enzymes indicating possible hepatic injury.
• Neutropenia or other blood dyscrasias.

When prescribing Montelukast, clinicians should consider several precautionary measures to ensure safe use.

• Liver function monitoring: assess baseline hepatic enzymes and re‑evaluate periodically.
• Neuropsychiatric observation: watch for mood changes, depression, or suicidal ideation.
• Severe hepatic impairment: use with caution or avoid in patients with marked liver disease.
• Hypersensitivity: discontinue if rash, angioedema, or anaphylactic signs appear.
• Pregnancy and lactation: evaluate risk‑benefit as category B; discuss with patient.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Montelukast may interact with other medicines that affect its metabolism or pharmacodynamic profile.

Major Interactions (Avoid)

• Phenobarbital: enzyme induction can markedly reduce montelukast plasma concentrations.
• Rifampin: strong CYP inducer leading to decreased therapeutic effect.
• Ketoconazole: potent CYP inhibitor may increase montelukast levels and risk of adverse events.

Moderate Interactions (Monitor Closely)

• Warfarin: possible increase in INR; monitor coagulation parameters.
• Beta‑agonists: additive bronchodilatory effects may require dose adjustment.